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Nursing for Australia Health System

Question:

Discuss about the Nursing for Australia Health System.

Answer:

Introduction:

The provision of affordable, quality health care is a difficult challenge. Due to the complexities involved, studying health care system gives the insight to understand the use, cost, quality, delivery, accessibility, organization, financing and is a key to informing the government authorities to take suitable measures accordingly. Health care coverage has become so expensive that for many countries, it has become a challenge, including the developed and modern nations such as United States (U.S) and Australia. In fact, the health care delivery has become a big business lately. This article examines the health care system of US and Australia and explain the models adopted by each country to tackle health issues in the both the countries. It explains the policy implemented in both countries to improve health care outcome among indigenous population. Finally analysis of strength and weakness of health care system helps in identifications of efforts taken by both countries to improve health outcome

Australian healthcare system is very complex involving a variety of funders and healthcare providers. Health care responsibility is divided between both government and non-government sectors. Australian government handles the majority of funding of health care system and also provided by territory and local governments, health insurers and other sources. There is universal benefit scheme like private medical services (PBS), Medicare and private health insurance rebate. The objective of Australian health care system is to provide a balance of government and health services so that all Australians can avail universal care free of cost or at much lower cost (Grol et al., 2013). While the Australia has a system of social justice which believes in providing basic health care to all citizens, US health care system has a system of market justice. In Australia, the primary concern is about health care delivery to Aboriginal population due to their rural location. Similarly, the US face the same kind of issues with American Indians due to poor health among them. Both countries are having a problem in managing the health of the indigenous population. US health care system is very much fragmented as there is no centralized authority to look after distribution, placement and delivery of health care resources to increase accessibility and provide best health outcome (Zimlichmann et al., 2013). Lack of centralized planning in the region has lead to an imbalance in the number of physicians available in the rural and urban areas. Compared to Australian health system, it has a relatively small proportion of health insurance scheme. The two public health insurance programs in the US are Medicare and Medicaid, and the difference lies in the way they are administered and funded (Berwick & Hackbarth, 2012).

Medicare is a universal insurance scheme model implemented in Australia since 1984. Through this, the aim is to provide free or subsidized health service. The Medicare system covers hospital, medical and pharmaceutical setting. In public hospitals, Medicare provides free treatment for patients and subsidized cost on a broad range of prescription medicines under pharmaceutical benefits scheme. This is done by offering rebates on clinical investigations and consultations in medicine (Squires & Anderson, 2015). The prominent areas have a private healthcare system which is large, where approximately 40% of the total population who also holds private insurances. They have the option of opting for a private hospital, their doctor as well as the option for shorter wait for healthcare procedures. Australia even tried to use the legislation to remove some escalations in finances, however as it has a unified system, the legislation focuses more on incentives to reduce government payouts, eventually saving money of the government and reducing the costs paid by the government (Wong et al., 2016).

Similarly, In 1965, US government has developed a model for Medicaid and Medicare program, to provide healthcare to citizens aged 65 and older as well as lower income patients. Medicaid health insurance program is paid for by state and federal taxes, and its eligibility is determined by the state. The state government negotiates with health care providers to determine eligibility. There are safety webs to protect populations which are vulnerable such as Medicaid or low-income people. If families do not qualify for Medicaid based on income, then State Children’s Health Insurance Program covers those families. The Medicare insurance program covers seniors and other groups and paid by payroll taxes (KanavoS ET AL., 2013). This model is distributed to people above 65 years of age, and its eligibility is determined by the federal government.  In the case of US, the country faces challenges in its effort to reform and improve the system's efficiency which requires the cooperation of stakeholders ("Forbes Welcome," 2016).

Although the US is the only country that lacks a publicly financed health care system, buts its overall health care expenditure for better health outcome far exceeds that of other nations. With better use of expensive technology in health care, they have reduced the number of hospital admissions. However, they lag behind regarding health outcome measures such as life expectancy and rate of chronic diseases (Faden et al., 2013). The mortality rate from cancer has decreased in the US compared to other countries; the contrasting report is that mortality rate due to ischemic heart disease has also increased (Squires & Anderson, 2015). The Australian health care system expenditure on health has grown faster in the past few decades. Every year the health spending is increasing by 5.4% compared to last year. Australian health care model's majority spending is in hospitals, primary health care, capital expenditure and recurrent expenditure. The most expense is on cardiovascular disease, oral health, and mental disorder. About heath care service for Aboriginal and Torres Strait Islander, Australia spends 3.7% of total health expenditure on them ("Australia's health system (AIHW)", 2016).

Australian health system is committed to the delivery of efficient health service for Aboriginal and Torres Strait Islander people. They plan to do so by Medicare, pharmaceutical benefits scheme and investment on Indigenous-specific health programs. The policy of Indigenous Australian Health Programme focuses on primary health care funding and the Aboriginal and Torres Strait Islander Chronic Disease Fund (Dudgeon et al., 2014). A funding allocation methodology is a plan by the Department of Health that ensures investments in the area of addressing the need of indigenous population and delivering improved health outcome. There is also an activity for achieving health equity between indigenous and non-indigenous Australian citizens (Donato & Segal, 2013).  For example, they are working in the area of chronic disease prevention, management, and child and maternal health. The delivery of health care to this section of the population is dependent on cultural competency skills. Indigenous people are profoundly influenced by their particular cultural in life, so understanding this aspect is important. Cultural competency is an approach to reduce inequality in access to health care and improving the quality of life of the indigenous population of Australia. The health care delivery is affected by this social factor of the populations and so developing cultural competency requires the focus of Australian health care system to provide awareness about behavior and attitude of this section of the population (Clifford et al., 2015).

There is huge diversity related to culture and language among indigenous population worldwide. There several gaps in the social determinant of health among American Indians in the US. The minority population of US suffers from poor health due to the high rate of diabetes, pulmonary disease, and cardiovascular population. To improve health care delivery among Native Americans knowledge about the impact of colonization and its effect on these people is essential. Racism and discrimination still exist in the American medical system (Viruell-Fuentes et al., 2012). They have implemented policies such as a healing fund for them which will look at the emotional, physical and cultural trauma of Native Americans. There is the Native Wellness Program that looks after health and wellness issues of Native Americans. Any national policy will be successful only when health care staff has an understanding about cultural issues of Native Americans, and this issue has contributed to health problems among them. The Native Wellness program should work from grass root levels to incorporate cultural sensitivities and address health issues of Native Americans (Rushing et al., 2015).

The major strength of American health care systems is its control by private sectors. It has facilitated ready access to all kinds of health service with stable coverage and has encouraged medical innovation. The rapid advance in medical technology has improved the health status of American citizens. But employer-based health coverage is the primary weakness of health care system as it leaves large gaps in those people who do not have stable jobs. This is the reason for rapid cost escalation (Drummond et al., 2015). The strength of Australian health care system is that the country ranks well internationally regarding maintaining high average life expectancy and low infant mortality. But Australian health systems I weakened by issues like the burden of chronic disease and aging population. Inequality in health persists among indigenous and urban citizens of Australia. This means the lot needs to done to address these challenges in the delivery health care system (Best et al., 2012).

The Medicare program of Australia highlights the countries health care system. This Universal health care scheme does the primary funding for health care delivery in Australia. By this program, Australian citizens are entitled to subsidized treatment from health care practitioners, midwives, nurses, etc. This scheme was introduced as Medibank scheme in 1975. It now covers the majority of health care cost. One can choose between a combination of Medicare and private health care insurance. It reimburses 100 % of Medicare Benefits Schedule when citizens visit a doctor outside the hospital. It is beneficial for different surgical procedures performed by the physician. By pharmaceutical benefit scheme, people has to pay a small part of the cost for prescribed medicines and rest cost is covered by pharmaceutical benefits scheme. It is beneficial for specific items under Enhanced Primary Care Program (Berkman et al., 2013).

Conclusion

This report covers the detail about health care system of two advanced countries in the world-Australia and United state. The comparison between the two system has helped in the understanding of complexities prevalent within the system. The informational is useful in the identification of challenges and addressing issues in the health care system. The comparison about health funding scheme gives useful into work of private and non-private sector regarding improving health care delivery and access to health. Both the country has focused on the health of the indigenous population. Their life is influenced a lot by their culture and needs the for improving cultural competency skill has been rightly identified by both. Reforms in patient safety, professional roles and changed in the academic curriculum can be adapted to move towards more evidenced based medicine. Multiple data resources which include medical records, surveys on patients, as well as administrative data, can be utilized. Innovative answers to the future of healthcare or present challenging issues by exposing the underlying issues and problems can fast track certain needlessly wrong processes and expenses by providing a better and comprehensive way to tackle the upcoming issues of healthcare.

References

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Berkman, N. D., Lohr, K. N., Ansari, M., McDonagh, M., Balk, E., Whitlock, E., ... & Hartling, L. (2013). Grading the strength of a body of evidence when assessing health care interventions for the effective health care program of the Agency for Healthcare Research and Quality: an update.

Berwick, D. M., & Hackbarth, A. D. (2012). Eliminating waste in US health care. Jama, 307(14), 1513-1516.

Best, A., Greenhalgh, T., Lewis, S., Saul, J. E., Carroll, S., & Bitz, J. (2012). Large‐system transformation in health care: a realist review. Milbank Quarterly, 90(3), 421-456.

Clifford, A., McCalman, J., Bainbridge, R., & Tsey, K. (2015). Interventions to improve cultural competency in health care for Indigenous peoples of Australia, New Zealand, Canada and the USA: a systematic review.International Journal for Quality in Health Care, 27(2), 89-98.

Donato, R., & Segal, L. (2013). Does Australia have the appropriate health reform agenda to close the gap in Indigenous health?. Australian Health Review, 37(2), 232-238.

Drummond, M. F., Sculpher, M. J., Claxton, K., Stoddart, G. L., & Torrance, G. W. (2015). Methods for the economic evaluation of health care programmes. Oxford university press.

Dudgeon, P., Milroy, H., & Walker, R. (2014). Working together: Aboriginal and Torres Strait Islander mental health and wellbeing principles and practice. Pat.

Faden, R. R., Kass, N. E., Goodman, S. N., Pronovost, P., Tunis, S., & Beauchamp, T. L. (2013). An ethics framework for a learning health care system: a departure from traditional research ethics and clinical ethics.Hastings Center Report, 43(s1), S16-S27.

Forbes Welcome. (2016). Forbes.com. Retrieved 8 August 2016, from http://www.forbes.com/sites/paulhsieh/2014/03/31/what-the-us-can-learn-from-australia/#615a7e5c7ac5

Grol, R., Wensing, M., Eccles, M., & Davis, D. (Eds.). (2013). Improving patient care: the implementation of change in health care. John Wiley & Sons.

Kanavos, P., Ferrario, A., Vandoros, S., & Anderson, G. F. (2013). Higher US branded drug prices and spending compared to other countries may stem partly from quick uptake of new drugs. Health Affairs, 32(4), 753-761.

Rushing, S. C., Gaston, A., Kaufman, C., Markham, C., Jessen, C. M., Gorman, G., ... & Lane, T. L. (2015). 10 Using Technology to Promote Health and Wellbeing among American Indian and Alaska Native Teens and young Adults. Indigenous People and Mobile Technologies, 31, 163.

Squires, D. & Anderson, C. (2015). U.S. Health Care from a Global Perspective.Commonwealthfund.org. Retrieved 8 August 2016, from http://www.commonwealthfund.org/publications/issue-briefs/2015/oct/us-health-care-from-a-global-perspective

Viruell-Fuentes, E. A., Miranda, P. Y., & Abdulrahim, S. (2012). More than culture: structural racism, intersectionality theory, and immigrant health.Social science & medicine, 75(12), 2099-2106.

Wong, C. Y., Greene, J., Dolja‐Gore, X., & Gool, K. (2016). The Rise and Fall in Out‐of‐Pocket Costs in Australia: An Analysis of the Strengthening Medicare Reforms. Health Economics.

Zimlichman, E., Henderson, D., Tamir, O., Franz, C., Song, P., Yamin, C. K., ... & Bates, D. W. (2013). Health care–associated infections: a meta-analysis of costs and financial impact on the US health care system. JAMA internal medicine, 173(22), 2039-2046.

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